Propranolol: A 50-year historical perspective

Abstract

Propranolol is a beta-adrenergic receptor antagonist that was developed by the British scientist Sir James Black primarily for the treatment of angina pectoris, more than 50 years ago. It was not long before several other cardiovascular as well as noncardiovascular therapeutic uses of propranolol were discovered. Propranolol soon became a powerful tool for physicians in the treatment of numerous conditions such as hypertension, cardiac arrhythmias, myocardial infarction, migraine, portal hypertension, anxiety, essential tremors, hyperthyroidism, and pheochromocytoma. Owing to its action at multiple receptor sites, propranolol exerts several central and peripheral effects and is therefore useful in various conditions. Right from reduction in postmyocardial mortality to control of anxiety in performers, propranolol plays an important role in a plethora of medical conditions. Interestingly, even today, newer indications of this age-old drug are being discovered. Moreover, propranolol treatment has been found to be cost-effective when compared to other corresponding treatment options for individual indications. In this article, we attempt to recount the journey of propranolol right from its inception to the present day.

Cavefish brain atlases reveal functional and anatomical convergence across independently evolved populations

“…Pharmacological manipulations can act on numerous populations of neurons and have secondary effects. For example, propranolol, a drug that potently induces sleep in cavefish, is used to treat both anxiety and heart disorders ( 33 , 54 , 55 ). It is therefore possible that the neural signatures shown here are representing a wide range of physiological responses in regions such as the habenulae and pallium, which underlie stress regulation or other responses in addition to their measurable effect on sleep (table S5).…”

Effect of Propranolol with and without Rosuvastatin on Migraine Attacks: A Triple Blind Randomized Clinical Trial

“…Moreover, the great statin-associated decrease in the risk of atherothrombotic stroke, total stroke and other cardiovascular events is considerably more than possible side effects of these drugs [25]. Meanwhile, safety profile of propranolol in various conditions have been reported to be acceptable [26].…”

Hipertiroidismo

“…1 No caso do propanolol, para além de diminuir sintomas de hipertiroidismo, como palpitações e tremor, tem a vantagem adicional de diminuir a conversão periférica de tiroxina em triiodotironina, sendo esta última a hormona biologicamente ativa. 15 Nas situações de hipertiroidismo subclínico devem ser tratados todos os doentes com TSH < 0,1mU/L. 1,14 Nas situações de hipertiroidismo subclínico, com níveis de TSH entre 0,1 e 0,4mU/L (sendo 0,4mU/L o limite inferior do normal), o tratamento está recomendado em: todos os indivíduos de idade igual ou superior a 65 anos; pacientes com fatores de risco cardiovasculares, doença cardíaca ou osteoporose; e mulheres na pós-menopausa, sem terapêutica com estrogénios ou bifosfonatos instituída.…”